CT血管造影、血清SICAM-1检测在颅内动脉瘤及术后复查中的意义

Significance of CT Angiography and Serum SICAM-1 Detection in Intracranial Aneurysms and Postoperative Reexamination

目的研究CT血管造影(CTA)、血清可溶性细胞间黏附分子-1(sICAM-1)在颅内动脉瘤诊断及其术后复查中作用。方法将我院2016年1月至2018年1月间收治的41例行动脉瘤夹闭术患者纳为研究对象,其术前均行CTA与数字减影造影(DSA)检查,且发病72h内获得血清sICAM-1检测水平结果,术后1~3d,共11例患者行CTA复查。结果 41例患者在动脉瘤夹闭术中共发现45个动脉瘤,其中4例为多发;37例为单发,术前CTA检查共发现40个,漏诊5个,检出率为88.89%;DSA共发现43个,漏诊2个,检出率为95.56%;CTA对直径≤3mm的动脉瘤检出效果低于DSA,但无显著性差异(P>0.05)。术后1~3d,11例患者行CTA复查,发现1例未完全夹毕,再次手术调整瘤夹位置给予夹毕;CTA复查提示7例患者存在脑血管痉挛(CVS)现象,统计发现,术后CVS者入院血清sICAM-1水平显著高于非痉挛者(P<0.05);经相关性分析提示,入院时血清sICAM-1水平与患者术后CVS发生间呈正相关(r=0.364,P<0.05)。结论 CTA与DSA在诊断颅内动脉瘤中的效果相当,且CTA具有检查方便、无创性的优势,在颅内动脉瘤夹闭术后随访中也具有良好的应用价值,积极检测患者入院时血清sICAM-1水平在评估其术后CVS发生风险中具有良好的参考价值。

Objective To study the effects of CT angiography(CTA)and serum soluble intercellular adhesion molecule-1(sICAM-1)in the diagnosis and postoperative eexamination of intracranial aneurysms.Methods Forty-one patients with aneurysm clippings admitted to our hospital from January 2016 to January 2018 were enrolled in the study.All patients were given CTA and digital subtraction angiography(DSA)before surgery,and the detection level of serum sICAM-1 was obtained within 72h after onset.At 1d to 3d after surgery,a total of 11 patients were given CTA reexamination.Results A total of 45 aneurysms were found in 41 patients with aneurysm clipping,among which 4 cases were multiple and 37 cases were single.A total of 40 aneurysms were found by CTA examination before surgery,and 5 aneurysms were missed diagnosis,and the detection rate was 88.89%.A total of 43 aneurysms were found by DSA and 2 aneurysms were missed,and the detection rate was 95.56%.The detection effects of CTA on the aneurysm with diameter≤3mm were lower than those of DSA(P>0.05).At 1d to 3d after surgery,11 cases were given CTA reexamination,and 1 case was found not fully clipping and given surgery again to adjust tumor clip position for clipping.The CTA reexamination showed that there were cerebral vasospasm(CVS)in 7 cases,and it was found that the serum sICAM-1 level at admission of postoperative CVS patients was significantly higher than that of patients without spasm(P<0.05).Correlation analysis showed that serum sICAM-1 level at admission was positively correlated with postoperative CVS occurrence(r=0.364,P<0.05).Conclusion CTA and DSA have the same effects in diagnosising intracranial aneurysms,and CTA has the advantages of convenient and non-invasive examination,and it has good application value in the postoperative follow-up of intracranial aneurysm clipping,and actively detects the serum sICAM-1 level of patients at admission,and it has a good reference value in assessing the risk of postoperative CVS.